Does race impact survival for patients with anal squamous cell carcinoma?. Issue 7 (23rd September 2019) - Fields, Adam C.
Abstract: Background/Objectives: Racial disparities are known to impact cancer outcomes. The aim of this study was to assess current racial disparities in outcomes of anal squamous cell carcinoma (SCC). Methods: The National Cancer Database was used to identify patients with anal SCC. The primary outcome was 5‐year overall survival. Results: There were 32 255 (88.1%) White patients and 4342 (11.9%) Black patients identified with anal SCC. Compared to White patients, Black patients were more likely to be younger, have lower median income, and be insured with Medicaid (all P < .001). The 5‐year overall survival of Black and White patients for stage I disease was 71.2% and 80.6% ( P < .001), for stage II disease, was 64.6% and 69.3% ( P = .001), for stage III disease was 50.9% and 58.1% ( P < .001), and for stage IV disease was 22.1% and 21.9% ( P = .20). In a cox regression analysis, Black race was associated with significantly worse survival in stage I (HR: 1.37, 95% CI: 1.07‐1.76, P = .01), stage II (HR: 1.30, 95% CI: 1.14‐1.48, P < .001), and stage III disease (HR: 1.31, 95% CI: 1.16–1.47, P < .001) but not for stage IV disease (HR: 1.09, 95% CI: 0.89‐1.35, P = .41). Conclusions: Black race is correlated with worse survival in patients diagnosed with anal SCC. This disparity in survival is likely multifactorial and requires further study.